Columbia University Medical Center's (CUMC) CTSA and Irving Institute for Clinical and Translational Research (IICTR), using the expertise and commitment of faculty in 10 Key Resources have made outstanding progress toward the goal of transforming the culture of clinical and translational (C/T) research at CUMC. Examples include: novel projects using interdisciplinary approaches; a novel, 2-phase inter- disciplinary pilot award program that has already captured several NIH grants; a Website for all service request that also has a faculty directory that facilitates collaborative research; 5 hours of free consultation to more than 600 investigators leading to 33 NIH grants and 106 publications; collaboration among several CUMC regulatory groups that has significantly improved contracting, IRB time-to-approval, and ethics education/consultation services; successful launch of satellites research facilities in ICUs and EDs resulting in 50 new investigators conducting 30 new protocols; opening of the Columbia Community Partnership for Health center, one-half mile from CUMC. as a home for community-based organizations and community- based participatory research; launching of a new Master's degree in POR, a novel one year certificate curriculum within existing T32 programs, and an outstanding KL2 program with 9 scholars already capturing independent funding; and transformation of the old GCRC core laboratory into a campus-wide biomarkers core serving T1, T2 and T3 investigators. Throughout, our Tracking and Evaluation Group has provided critical assistance regarding future direction. Most importantly, we have validated the concept of the CTSA and are changing the culture of research at CUMC. In the next 4 years, with institutional support of nearly $4 million yearly, we will build upon this foundation and (1) Expand the resources and infrastructure that we have developed for T2 and T3 clinical researchers; (2) Capitalize on CUMC's outstanding T1 discovery research community by integrating existing resources and investigators even more closely into our CTSA. (3) Improve the health of our community by working with the NYPH ambulatory care network and community based organizations to develop platforms for comparative effectiveness research.